Case Study: Treatment Plan Goals / Objectives

Note: Always make objectives measurable, e.g., 3 out of 5 times, 100%, learn 3 skills, etc., unless they are measurable on their own as in “List and discuss [issue] weekly…”

Abuse/Neglect

Goal: Explore and resolve issues relating to history of abuse/neglect victimization

• Share details of the abuse/neglect with therapist as able to do so
• Learn about typical long term/residual effects of traumatic life experiences
• Develop two strategies to help cope with stressful reminders/memories

Alcohol/Drugs and Other Addictions

Goal: Be free of drug/alcohol use/abuse

• Avoid people, places and situations where temptation might be overwhelming
• Explore dynamics relating to being the [child/husband/wife] of an [alcoholic/addict] and discuss them each week at support group meetings
• Learn five triggers for alcohol & drug use
• Reach ____ days/months/years of clean/sober living

Adoption/Foster Care Placement

Goal: Explore and resolve issues related to adoption/out-of-home placement

• Discuss ongoing concerns and issues related to adoptive and/or biological parents during weekly sessions
• Talk about his/her wishes with regard to permanency planning

Anger

Goal: Increase and practice ability to manage anger

• Walk away from situations that trigger strong emotions (100%)
• Be free of tantrums/explosive episodes
• Learn two positive anger management skills
• Learn three ways to communicate verbally when angry
• Be able to express anger in a productive manner without destroying property or personal belongings
• Be able to express anger without yelling and using foul language
• Explore and resolve conflict with ____ (list triggers)
• Get through an entire day without an angry mood swing (or breaking/punching…)
• Get through a whole week without fighting with ____
• Take a time-out when things get upsetting
• Learn and practice anger management skills especially in situations where people are not treating him/her respectfully

Anxiety

Goal: Develop strategies to reduce symptoms, or Reduce anxiety and improve coping skills

• Be free of panic episodes (100%)
• Recognize and plan for top five anxiety-provoking situations
• Learn two new ways of coping with routine stressors
• Report feeling more positive about self and abilities during therapy sessions
• Develop strategies for thought distraction when fixating on the future

Behavior Problems

Goal: Improve overall behavior (and attitude/mood), or Maintain positive behavior (and attitude/mood)

• Be free of _____ behavior
• Develop a reward system to address ___ (target problem)
• Learn two ways to manage frustration in a positive manner
• Share two positive experiences each week in which X is proud of how he/she has behaved
• Stay free of fights
• Stay free of drug & alcohol use and abuse (100%)
• Be free of violent behavior
• Be able to keep hands and feet to self
• Be able to express anger in a productive manner without destroying property or personal belongings
• Be free of threats to self and others
• Complete daily tasks (e.g. chores, pet care, self care, etc.)
• Avoid leaving clothing/toys/personal stuff all around the house
• Listen to parent and follow simple directions with one prompt
• Put all dishes, glasses, cups, and food items back in the kitchen after meals/snacks
• Clean up after himself/herself
• Admit and accept personal responsibility for own actions/behavior
• Be respectful of adults and avoid talking back
• Get through a whole week without fighting with ____
• Avoid behavior that would result in a loss of custody
• Be able to play with others peacefully for ____ minutes
• Come home each day by ______ (time)
• Keep parents informed about where you are and when you will be home
• Be in bed by _____ each night
• Be free of bedwetting
• Be free of wet/soiled underwear
• If an accident happens, be responsible and clean it up
• Be free of any behavior that could result in loss of job
• Remain free of behaviors which would lead to arrest
• Comply with all aspects of probation/parole and avoid behavior that could violate
• Eat/swallow only items intended to be food

Communication Skills

Goal: Learn and use effective communication strategies

• Talk nice or do not say anything at all
• Learn three ways to communicate verbally when angry
• Be able to express anger in a productive manner without destroying property or personal belongings
• Be able to express anger without yelling and using foul language
• Be able to express wants and needs through spoken language
• Be able to ask questions and tell about instances
• Be able to stick up for self assertively
• Speak in a clear and concise manner so others fully understand him/her
• Learn to express feelings verbally without acting out

Crime

Goal: Remain free of behaviors which would lead to arrest/violation

• Keep working and comply with all aspects of probation
• Be able to express anger in a productive manner without destroying property or personal belongings
• Be free of threats to self and others
• Comply with all aspects of probation/parole and avoid behavior that could violate
• Be free of violent behavior
• Stay free of drug & alcohol use and abuse (100%)

Decision Making

Goal: Improve decision making skills

• Make short and simple “to do” lists and complete three tasks each day
• Celebrate little successes each day using positive self talk and/or journaling
• Be able to weigh options and make simple decisions within 5 minutes
• List three options for any major decisions and then discuss with therapist or family

Depression

Goal: Improve overall mood

• Be free of suicidal thoughts
• Call crisis hotline if having suicidal thoughts
• Report feeling more positive about self and abilities
• Get 7-8 hours of restful sleep every night
• Avoid napping/sleeping to escape other people and activities
• Shower, dress, and then do something every day
• Report feeling happy/better overall mood
• Make short and simple “to do” lists and complete three tasks each day
• Celebrate little successes each day using positive self talk and/or journaling
• Get through a day/week without a crying spell
• Develop strategies for thought distraction when ruminating on the past

Eating Disorders

Goal: Resolve eating disorder

• Eat a balanced diet of foods and maintain good overall health
• Gain ____ pounds
• Loose ____ pounds
• Be free of binge eating/purging
• Remove junk foods from home and limit future purchases
• Recognize/list environmental and situational triggers and develop alternative behaviors for coping with them
• Recognize emotional triggers and develop alternative ways of strategies for meeting emotional needs

Enuresis and Encopresis

Goal: Be free of wetting/soiling

• Avoid drinking near bedtime
• Eat high-fiber foods and avoid foods that constipate
• Go to the bathroom before going out of the house
• Sit on the toilet for 10-15 minutes after meals
• Avoid hiding wet/soiled clothing
• Take responsibility for helping clean up (e.g., put wet/soiled items in soak bucket)

Expression of Feelings, Wants and Needs

Goal: Learn appropriate ways to express different feelings

• Share two positive experiences each week in which client is proud of how he/she has behaved
• Gain knowledge of different feelings
• Turn to adults for help when feeling sad, angry or negative feelings
• Express feelings verbally rather than whine and/or cry about them
• Learn to express feelings verbally without acting out

Family Conflict

Goal: Learn and use conflict resolution skills

•   Recognize patterns of family conflict  discuss weekly in therapy
•   Avoid angry outbursts by walking away from stressful situations
•   Get through X days out of 7 without fighting with siblings
•   Be respectful of ____: Listen, follow directions and avoid talking back
•   Be able to live together peacefully, free of all angry physical contact
• Learn three ways to communicate verbally when angry
• Be able to express anger without yelling and using foul language
• Explore and resolve conflict with ____
• Be able to stick up for self assertively, not aggressively
• Be respectful of adults/don’t talk back
• Get through a whole week without fighting with ____
• Speak in a clear and concise manner so others fully understand him/her
• Learn to express feelings verbally without acting out

Grief and Loss

Goal: Explore and resolve grief and loss issues

• Give sorrow words - discuss issues of grief weekly with therapist
• Continue to explore and resolve issues of grief/loss as they arise
• Get through a week without a crying spell
• Learn about the typical 2-7 year process of grieving the loss of a loved one
• Explore spirituality and the role it plays in redefining views about the meaning and purpose of life
• Create (write/draw) a soul sketch of the deceased loved one
• Plan a memorial service for the anniversary of the loss
• Develop appropriate rituals to remember and honor _____

Harm to self or others

Goal: Be free of thoughts of self-harm/self mutilation, or Be free of thoughts to harm to others

• Learn two ways to manage frustration in a positive manner
• Explore triggers of thoughts to harm self or others
• Call crisis hotline when needed
• Report feeling more positive about self and abilities
• Explore and resolve stress from ____
• Develop a crisis plan and share it with key people
• Remove weapons from the home [and other means]
• List three emergency contacts who will be able to stay with you till a crisis passes

Health Issues

Goal: Manage physical healthcare conditions and cope with related stress

• Learn as much as possible about the condition(s) and needed treatment
• Take medications/treatments as prescribed on a daily basis
• Attend all scheduled appointments with the doctor
• Maintain good overall physical health and healthcare practices
• Report any medication concerns to the prescribing doctor ASAP
• Seek additional advocacy services from _____
• Seek additional support from _____

Hyperactivity

Goal: Improve overall behavior, or Maintain positive behavior

• Be able to keep hands and feet to self
• Complete daily tasks (e.g. chores, pet care, self care, etc.)
• Listen to parent/teacher and follow simple directions with one prompt
• Behave in an age-appropriate manner
• Maintain passing grades
• Will be able to focus attention and complete school-related tasks each day
• Listen and take notes in all classes
• Will review homework and other projects with parents on the day they are assigned
• Be respectful of adults and avoid talking back
• Be able to play with others peacefully for ____ minutes
• Be free of any behavior that could result in detention/suspension
• Develop a reward system to address ____ (target problem)

Medication Management

Goal: Medication management

• Take medications as prescribed on a daily basis
• Attend all scheduled appointments with the psychiatrist
• Maintain good overall physical health and healthcare practices
• Report any medication concerns to the doctor ASAP

Mood Management

Goal: Maintain stability of mood, or Improve overall mood, or Maintain even mood, or Increase ability to manage moods

• Learn two ways to manage frustration in a positive manner
• Be free of suicidal thoughts; call crisis hotline if having suicidal thoughts
• Report feeling more positive about self and abilities
• Report feeling happy/better mood (4 days out of 7)
• Get 7-8 hours of restful sleep every night
• Get through a week without a crying spell

Parenting

Goal: Improve parenting skills

• Set two limits and stick with a plan that will require more responsible behavior
• Focus on positive behavior and give attention then, rather than focus on negative things
• Learn and be able to effectively use transactional analysis to stay in “adult” mode
• Use “I” statements rather than You” when communicating with _____
• Develop and consistently use a behavior modification plan, to increase/eliminate _____

Personal Hygiene and Self-care

          Goal: Improve personal hygiene and attentiveness to independent/age appropriate self-care

• Brush teeth ____ times each day and floss _____
• Shower (take a bath) every day
• Use antiperspirant / deodorant every day after showering
• Brush/comb hair every morning
• Do a thorough job of wiping after toileting (100%)

Physical Health Issues

Goal: Cope with stress of physical health issues and chronic pain

• Explore and resolve thoughts and feelings that arise as a result of medical conditions and medications
• Learn two new strategies for coping with the above thoughts and feelings
• Reduce weight by _____  pounds
• Exercise for 20 minutes every day
• Learn strategies to advocate for him/herself with medical personnel
• Quit smoking (or drinking)
• Take medications as prescribed on a daily basis
• Attend all scheduled appointments with physicians
• Maintain good overall physical health and healthcare practices
• Report any medication concerns to the doctor ASAP
• Make and keep an appointment with _____ (dentist) for needed diagnosis and treatment

Relationships

Goal: Establish/maintain civil and supportive behavior

•    Avoid angry outbursts by walking away from stressful situations
•    Be free of affairs
•    Be able to live together peacefully, free of all angry physical contact

• Learn three ways to communicate verbally when angry
• Explore peer and dating relationships to improve X’s chance of staying safe and legal
• Be able to keep hands to self
• Be able to express anger without yelling and using foul language
• Explore and resolve conflict with ____
• Be able to stick up for self assertively
• Be respectful of parents/don’t talk back
• Get through a whole week without fighting with ____
• Speak in a clear and concise manner so others fully understand him/her
• Be able to play with others peacefully for ____ minutes
• Learn to express feelings verbally without acting out
• Associate with healthy people and continue to make new friends
• Continue to explore relationship issues and slowly see new opportunities for dating
• Figure out why relationships fail and better plan for finding next partner
• Associate with people outside of work and make one or two new friends

School Issues

  Go to school every day

• Behave in an age-appropriate manner
• Maintain passing grades
• Will be able to focus attention and complete school-related tasks each day
• Listen and take notes in all classes
• Be free of suspensions and detentions
• Will review homework and other projects with parents on the day they are assigned

Self Image

Goal:  Explore and resolve issues related to self image

• Discuss life events that led to and/or reinforce a negative self image during weekly therapy
• Use positive self talk daily
• Exercise daily (or _____ times per week)
• Drop _____ pounds
• Report feeling more positive about self and abilities
• Return to school and work on getting _____ (degree/diploma/GED)
• Change jobs to one that…(offers more pay and/or better suits skill set)
• Openly discuss issues relating to sexuality and become comfortable with sexual identity
• Explore spirituality and the role it plays in the meaning and purpose of life
• Engage in volunteer work and/or other meaningful activity at least three hours each week

Sleep Problems

Goal:  Get 7-8 hours of restful sleep each night

• Limit consumption of food and drinks before bed
• Limit intake of caffeine (coffee, tea, soda) and chocolate after _____ (noon meal)
• Cut back on things that may impede normal sleep patterns (e.g., alcohol and some medications)
• Be in bed by _____ each night
• Have 30 minutes of quiet time before going to bed each night (e.g., read, meditate)
• Avoid overly stimulating shows/movies/video games before bedtime
• Avoid watching TV and chatting on the phone while in bed
• If not asleep in 20 minutes, get up and do something for a bit, rather than try to force sleep
• Leave a paper and pen to write worries down instead of ruminating on them
• Learn best practices for sleep (cooler room, limit caffeine, calming time before bed)
• Listen to relaxation/meditation music to aid falling asleep

Social Skills

Goal:  Improve social skills

• Speak in a clear and concise way so others fully understand him/her
• Learn to express feelings verbally without acting out
• Make a new same-age friend
• Spend two hours playing with peers each week

Stress

Goal: Be able to cope with routine life stressors and take things in stride

• Assess personal risk traits and resiliency traits and discuss the role each plays in coping with daily stresses during the time between therapy sessions
• Learn two ways to manage frustration in a positive manner
• Get 7-8 hours of restful sleep every night
• Talk out routine stress events during weekly therapy sessions
• Explore and resolve residual stress from ____ (e.g., years as a first responder)
• Foster two new activities/interests that will help mitigate stress
• Exercise 20-30 minutes per day
• Learn and use meditation and relaxation techniques daily

Suicide

Goal:  Be free of suicidal thoughts/attempts

• Explore and resolve stress from ____
• Call crisis hotline if having suicidal thoughts
• Develop a crisis plan and share it with key people
• Remove weapons from the home [and other means]
• List three emergency contacts who will be able to stay with you till a crisis passes

Thought Disorder

Goal:  Improve ability to see world as others do

• Be free of false perceptions and [see/hear/smell/feel] things as others do
• Be free of false beliefs
• Be free of thoughts that others are out to get you
• Spend 2-3 hours each week visiting with others
• Visit the clubhouse and/or the consumer drop-in-center each week
• Report feeling comfortable spending time with others

Trauma

Goal:  Explore and resolve issues related to ____ (traumatic event)

• Explore and resolve residual stress from ____ (e.g., years as a first responder)
• Share details of the trauma with therapist, as able to do so
• Reframe negative perceptions, when possible, and focus on finding meaning and drawing strength from the event
• Learn about typical long term/residual effects of traumatic life experiences
• Explore spirituality and the role it plays in life after traumatic events
• Learn about the typical 2-7 year process of rebuilding life after trauma

Vocational/Educational

Goal:  Find a new job, or Keep present job, or Re-enter the work force, Earn G.E.D.

• Explore options for returning to school/training
• Become an active member of a local clubhouse
• Complete college/technical school
• Develop a resume
• Seek  two people who will serve as references
• Be free of any behavior that could result in loss of job/educational grants
• Find and settle into a new job

TREATMENT PLAN INTERVENTIONS (FOCUSING ON: ______)

• Acceptance (of limitations/reality)
• Accountability
• ACOA Issues
• Anger Management (e.g., punch bag/pillow)
• Art Therapy
• Assertiveness Training
• Behavior Modification (e.g., rewards)
• Best Practices for ____ (e.g., better sleep)
• Bibliotherapy
• Building on Strengths
• Career Counseling
• Coaching
• Cognitive-Behavioral Therapy
• Communication Skills
• Community
• Conflict Resolution
• Couples Therapy
• Crisis Planning
• Defusing/Debriefing
• Dignity/Self-worth
• Discipline
• Drug & Alcohol Referral
• Education (e.g., graduation/GED)
• Empathy
• Empowerment
• Encouragement
• Expression of Feelings
• Fair Fighting Skills
• Family Therapy
• Feedback Loops
• Forgiveness
• Gestalt Therapy
• Getting a Job (Better Job)
• Goal Planning/Orientation
• Good Choices/Bad Choices
• Good Touch/Bad Touch
• Gratitude
• Grief/Loss/Bereavement Issues
• Homework Assignments
• Humility
• Increasing Coping Skills
• Independence
• Journaling
• Letting Go
• Life Skills Training
• Listening
• Logical Consequences of Behavior
• Magic Question (3 wishes/magic wand)
• Making Friends
• MISA/MICA Issues (Dual Dx Treatment)
• Modeling Appropriate Behaviors
• Money Management
• Monitoring of _____
• Motivation
• Narrative Therapy
• Normalization
• Parent Effectiveness Training/Skills
• Partializing (breaking down goals into manageable pieces)
• Patience
• Perseverance
• Personal Hygiene
• Play Therapy
• Portion Control (Weight Control)
• Positive Self-talk
• Primal Screams
• Priority Setting
• Practice Exercises
• Processing _____ (e.g., guilty feelings)
• Psychodrama
• Psychoeducation
• Reality Therapy
• Recognizing _____ (e.g., self destructive patterns of behavior)
• Refer to ______
• Reframing
• Rehearsal
• Relapse Prevention
• Relationship Issues
• Relaxation Techniques (e.g., breathing)
• Responsibility for Actions
• Role Playing
• Self-care Skills
• Self-direction (Independence)
• Sexual Identity Issues
• Sexuality
• Solution-focused Therapy
• Spiritual Exploration
• Starting Over
• Stop-Think-Act
• Strength Focus/Listing
• Stress Inoculation
• Stress Management
• Supportive Relationships
• Talk Therapy
• Therapeutic Stories & Worksheets
• Timeouts
• Transactional Analysis (P-A-C)
• Trigger Recognition
• Twelve Step
• Socialization
• Social Skills Training
• Social-Vocational Training
• Values Clarification
• Verbal Communication Skills
• Weight Control/Loss
• Workbooks

 

 

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